Developing Quality of Medication Error Reports (QoMER): A Consensus-Based Preliminary Framework Using a Modified Nominal Group Technique in the UK.

Abstract

To develop a consensus-based preliminary quality assessment framework using a modified nominal group technique (NGT) to describe the key indicators of an optimal medication error report (MER). A modified NGT consensus study comprising one face-to-face nominal group session and one round of follow-up emails using Microsoft Excel. A face-to-face consensus session took place in Birmingham, West Midlands, UK. A group of UK national medication safety experts and frontline healthcare professionals, including pharmacists, doctors and nurses (n=11), participated in the nominal group session. Of these, eight were female, and the rest were male. Panel members were selected based on their expertise or practice in medication safety. Non-UK medication safety experts and healthcare professionals were excluded from the study. The primary outcome was the development of the proposed Quality of Medication Error Reports (QoMER) framework. Secondary outcomes included the identification of key quality indicators (QIs) for high-quality MERs, inclusion votes, ranking scores and votes used to determine consensus and to inform the exploratory weighted scoring system. The proposed QoMER scoring framework comprises nine QIs organised under three main themes. The most prioritised QI was that the report should provide sufficient details of the patient and context. Participants ranked the weighted scoring approach as the most appropriate method for combining the completeness and perceived importance of each QI. Qualitative data, including audio-recorded discussions and written ideas, were transcribed and analysed inductively using Braun and Clarke's thematic analysis. Quantitative data, comprising inclusion votes, ranking scores and weighting values, were summarised descriptively. This integrated analytical approach ensured that both participant discussion and numerical agreement informed the final QoMER scoring framework. Medication errors lack qualitative depth in reporting, which affects learning, reflection and prevention. QoMER is proposed as a consensus-derived preliminary framework for the structured assessment and categorisation of MER quality by addressing nine QIs. These QIs may help promote more complete and actionable reporting, although further empirical validation is required before conclusions can be drawn about reliability, usability or impact on patient and medication safety.